Journal Notes: A Talk with International JGME Associate Editor Halah Ibrahim, MD, MEHP

This past December, Dr. Halah Ibrahim, one of the Journal of Graduate Medical Education’s (JGME’s) associate editors and co-author of the recent editorial, A Welcome to International Authors, was interviewed on JGME’s podcast, Hot Topics in MedEd. Along with her co-authors and fellow JGME editors Dr. Harm Peters and Dr. Lalena Yarris, she made an impassioned case for why Western-based medical journals need to do more to include global perspectives and encourage international authors. Currently, while inhabitants of low- and middle-income countries comprise the vast majority of the world’s population and bear most of the disease burden, authors from those countries are vastly underrepresented in the medical education literature. Dr. Ibrahim would like to see that change. “It is important,” she says, “for us to realize that patients, diseases, educators, and trainees move from one country to the other. And it is also important to recognize that educators around the world are doing great things. We need to give those educators, not just a voice, but the rewards and recognition in academic publishing for the work that they do.”   

We spoke with Dr. Ibrahim to learn more about her experiences with JGME and her commitment to bringing more geographical diversity to Western journals. Currently the Associate Dean for Clinical Affairs at Khalifa University College of Medicine in Abu Dhabi, she has been an associate editor with JGME since 2018. She moved from New York to Abu Dhabi in the United Arab Emirates (UAE) in 2008, which she says was fortunate timing for her as an educator. “Many changes were taking place in international medical education at that time,” she remembers. “Several countries, including Singapore and the UAE, were transitioning to competency-based medical education, and the ACGME was exploring the possibility of branching out internationally.” Indeed, in 2009 ACGME International was founded as a result those initial efforts. Through those connections, she was introduced to staff members and editors of the journal, contributing manuscripts on international GME, and eventually joining the Editorial Board.

In 2019 she was a co-editor and a driving force behind A Look into GME Around the World, a JGME supplement that brought together original research, educational innovation, and other novel ideas from a wide range of countries. The supplement took a great deal of effort, with a number of submissions going back and forth between authors and editors multiple times before going out for peer review. “We knew that if we sent them right to reviewers, they could be rejected, sometimes because of differences in style and language. But JGME does a good job in giving the editorial and writing support without asking the authors to go through a paid writing service. In many countries doing so becomes prohibitive and they just can’t do it.”

The efforts paid off. A Look into GME Around the World remains one of the most popular JGME issues, with articles published from more than 20 different countries. For Dr. Ibrahim, the rewards were also personal. “It was a great experience to interact with different authors in widely different settings—from the Netherlands to Eastern Europe, the Middle East, Africa, and the rest of Asia. Despite our different contexts, there were many common themes: how to do more with limited resources, how best to imbed professionalism in our curriculum, how to create best practices for faculty development when everyone is so busy.”

For Dr. Ibrahim, a large part of this work involves developing and encouraging cultural humility. “Educators, trainees, and patients come from all over the world, so a purely Western-centric approach to medicine cannot apply to all cases. For example, in a collectivist society, such as the UAE, we teach our residents how to maintain patient autonomy while still engaging and respecting family wishes. Other topics, such as spirituality in medicine, are also emphasized more than they may be in the West. That’s why dissemination of the work that is done in international GME can benefit all educators, regardless of country of practice.”

Fostering geographical and cultural diversity continues to be challenging work, but Dr. Ibrahim and JGME remain committed to removing many of the inherent barriers that international authors face. Some of these efforts include:

• Editorial support, when possible, to ensure that international innovation and research has the opportunity to reach a wider audience, despite differences in language and style;
• An open access and free submission policy that removes financial hurdles for those in lower-income nations who might otherwise be deterred; and,
• Active recruitment of an international reviewer community as well as efforts to improve the diversity and inclusivity of the editorial board.

As to the future, Dr. Ibrahim would like to see more collaboration across institutions and countries. “The recent JGME editorial is a great example: Harm Peters is in Germany, Lainie Yarris is in the United States, and I’m in the UAE. Meaningful work that adds value to the medical education literature is happening all over the world. My hope is that more journal editors and reviewers recognize this and openly welcome these diverse perspectives.”

Be sure to read and hear more from Dr. Ibrahim and her fellow editors in A Welcome to International Authors, as well as their engaging podcast conversation online at jgme.org, and explore the international research innovation collected in A Look into GME Around the World.

Guest blogger Kevin Gladish is an editorial associate on the staff of the Journal of Graduate Medical Education. He’s been at the ACGME since 2016, and is also a performer, writer, and storyteller.